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Both
plain gap and dermis fat arthroplasty are equally effective for treating
patients with ankylosis of the TMJ (temporomandibular joint).
In a recent study, it was found that both plain gap and dermis fat arthroplasty techniques have similar results in the treatment of ankylosis of the TMJ. Both techniques demonstrated similar outcomes at the end of three years’ follow up. No remarkable difference in mouth opening was witnessed.
A single-blind, randomized, controlled analysis was carried out to compare interpositional arthroplasty utilizing a dermis fat graft with gap arthroplasty in the management of TMJ ankylosis. From December 2014 to December 2015, this study recruited a total of 22 patients with ankylosis of the TMJ. Subjects were randomly assigned to either plain gap arthroplasty or dermis fat arthroplasty group.
The primary outcome measure was gain in mouth opening (maximum interincisal distance). The secondary outcome measure was pain during jaw exercises. On days 5 and 14, at the end of 1 and 6 months, and 1, 2 and 3 years, interincisal opening and pain were examined.
A
substantial difference was witnessed between both the groups on postoperative
day 5 and at one year. Results were
expressed as mean (SD). The mean (SD) scores for mouth-opening were elevated in
the dermis fat group at all times 41.20 (4.69) mm in comparison with 39.50
(2.46) mm in gap arthroplasty at two years, and 41.40 (3.60) mm compared with
38.9 (2.02) mm at three years as depicted in Table 1:
Postoperative pain scores in both groups were evaluated by a visual analogue scale (VAS). In the dermis fat graft group, the visual analogue pain scores were also lower as illustrated in Table 2:
Both the groups demonstrated
similar results at the end of three years follow up, with no remarkable
difference in mouth opening. Thus, both techniques can be utilized for managing
TMJ ankylosis.
British Journal of Oral and Maxillofacial Surgery
Is dermis fat arthroplasty better than plain gap arthroplasty? A prospective randomised controlled trial
N.N. Andrade et al.
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